Post-Chikungunya Chronic Inflammatory Rheumatism: An ethnographic vision of the social impact of disease in a cohort of 2-year follow-up in Colombia

Abstract

Background: Chikungunya virus (CHIKV), an alphavirus, is the causative agent of the CHIKV fever, an Aedes-borne disease that can lead to long-term sequelae in around half of patients, the post-CHIKV-chronic inflammatory rheumatism (pCHIK-CIR). This consequence can have also relevant social impacts, but few qualitative studies have explored this issue. Methods & Materials: Qualitative research methods consisted of 26 open and in-depth interviews in patients serologically diagnosed with CHIKV infection (IgM) during acute phase (<3 weeks) and follow-up for 2 years (chronic phase, pCHIK-CIR), in La Virginia municipality, Risaralda, Colombia, during July-October 2017. The analysis was made with emphasis on the ethnographic method. Results: It is evident that pCHIK-CIR affects routine performance and work of patients, in terms of efficacy as well continuity of daytime activities. Pain descriptions help to a better understanding of healthcare workers about the nature of social limitations of the patients. Patients with pCHIK-CIR, facing sharp physical limitations, tend to significantly modify their habits/life styles and creating “autotherapy” modalities. Conclusion: Patients need to establish sudden changes to try to solve the pain-related problems, affecting their life style, working activities and their relationships with other people. Treatment effective affordability lead them to search for unconventional alternatives, to learn to live with pain. The social impact of pCHIK-CIR manifests from different dimensions in the following context: since reduction of work capability, as well as efficiency in the continuity of common activities, of low or high impact, even reaching to the modification of life style, all of it to mitigate joint pains. These findings imply that the impact of pCHIK-CIR is not limited to clinical and biological consequences, but also extends to complex aspects such as the social life.